DrMalcolm Starkey

The Urinary Tract Health Research Program investigates the biology, diagnosis, and treatment of urinary tract infections (UTIs) and cystinuria, two major and often overlooked causes of chronic kidney disease and reduced quality of life. We combine immunology, microbiology, preclinical modelling, and translational research with cutting-edge technology to deliver solutions to address unmet clinical needs in urinary tract health. 

Our work spans fundamental discovery through to preclinical testing, with a strong emphasis on biomarker discovery, host‑directed therapies, and next‑generation diagnostic tools. We collaborate closely with clinicians, patient‑advocacy groups, philanthropy, and international industry partners to ensure our research has real‑world impact.

Current Research Themes

1. Urinary tract infection

UTIs are the cause of 405 million infections worldwide annually and are a major reason for antibiotic use. Crucially, over one-third of UTI patients fail to respond to current antibiotic treatment regimes, leading to recurrent infections, increased hospital admissions and severe renal complications. Compounding this, current diagnostics are alarmingly inadequate, missing over 50% of infections. This highlights the critical need for new non-antibiotic treatments and novel point-of-care diagnostics.

Our UTI research program aims to deliver transformative new knowledge to facilitate a paradigm shift in treating and diagnosing UTIs. The field’s current reliance and focus on antibiotic treatment strategies in the era of antimicrobial resistance pose a significant threat, and the current gold standard diagnostic test relies on outdated urine bacterial culture methods. To overcome these challenges, our research program aims to:

• Discover host immune pathways that can be targeted to improve urinary tract health
• Identify urinary biomarkers of infection
• Develop point-of-care diagnostics to rapidly detect urinary biomarkers

2. Cystinuria

Cystinuria is a rare genetic disease that leads to recurrent kidney stones. There are currently no effective treatments for cystinuria. To address this, our team has pioneered the development of a unique mouse model of cystinuria. Based on the most common pathogenic point mutation in the human SLC7A9 gene, this model faithfully replicates all the disease's critical features. We use this unique model to undertake unbiased screening to identify biomarkers for cystinuria and discover new therapeutic targets. In collaboration with International Industry partners, our model has proven to be highly effective for preclinical testing of small molecules and dietary interventions to progress lead candidates towards clinical development.  

Using this proprietary model, our team aims to:

• Understand the fundamental biological mechanisms driving cystinuria pathogenesis
• Discover novel biomarkers of disease onset and progression
• Develop and test new therapies e.g., small molecules, enzymes and gene therapy